Individual provider Active NPI

Mary Clair McGuire, NP

  • Family Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1386764819
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17890 Issued in MT
Practice address
4801 Veteran Drive
St. Cloud, MN 56303
Phone
(320) 252-1670
Fax
(320) 255-6359
NPI assigned
Mar 29, 2007
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 100238 MT
Family Nurse Practitioner 363LF0000X 17890 MT Primary

Addresses

Primary practice location

4801 Veteran Drive
St. Cloud, MN 56303

Mailing address

4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone (320) 252-1670

Other identifiers 1

IdentifierTypeStateIssuer
411768149OtherMEDICARE ID

Other names 1

  • Ms. Mary Clair McGuire Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000984 TX Practitioner - Nurse Practitioner 6103863832 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
100238MTMDGeneral Practice Physician
17890MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services CurrentSince Aug 23, 2004 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Aug 23, 2004 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

453 Pine Grove Rd
Hays, MT 59527
Phone (406) 353-3190

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1386764819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015",
            "telephone_number": "320-252-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERAN DRIVE",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-252-1670",
            "fax_number": "320-255-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "MARY",
        "middle_name": "CLAIR",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MT",
            "license": "100238",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "17890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "411768149",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCGUIRE",
            "middle_name": "CLAIR",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.